Miskolczi L, Guterman L R, Flaherty J D, Szikora I, Hopkins L N
Toshiba Stroke Research Center, Department of Neurosurgery, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, USA.
Neurosurgery. 1997 Jul;41(1):220-8; discussion 228-9. doi: 10.1097/00006123-199707000-00034.
To develop a new saccular aneurysm model in vitro using elastase to study aneurysm initiation, growth, and rupture and to create a new in vivo aneurysm model to test endovascular therapies.
Seventeen common carotid arteries excised from freshly killed pigs and sheep were treated with seven different methods of elastase delivery. The arteries were mounted in a saline-filled flow chamber. They received pulsatile flow for 48 hours, or until the resulting aneurysms ruptured. Changes were continuously monitored with video camera recordings and validated with histological sections.
All eight arteries treated topically, either on the intimal or on the adventitial surface, with elastase concentrations greater than 1 U/mm2, developed saccular aneurysms; five of them ruptured within 48 hours. All four arteries treated with surface concentrations of 0.1 U/mm2 via microcatheter infusion into the lumen developed fusiform aneurysms. None of the arteries that received surface concentrations less than 0.1 U/mm2 developed aneurysms. Histological sections revealed a reduced number of cellular element in a stretched collagen matrix at the dome of the saccular aneurysms.
After empirically testing several methods of elastase delivery, we were able to induce saccular, bifurcation-type aneurysms in animal arterial specimens. These aneurysms are histologically similar and more authentic than surgical models. The procedure is easy and reproducible. Our results suggest a possible enzymatic role in aneurysm formation and highlight the dramatic effects of selective arterial elastic damage. Also, the rapid growth of our experimental aneurysms may reflect the speed of the natural process.
利用弹性蛋白酶建立一种新的体外囊状动脉瘤模型，以研究动脉瘤的起始、生长和破裂情况，并创建一种新的体内动脉瘤模型来测试血管内治疗方法。
从刚处死的猪和羊身上切除17条颈总动脉，采用七种不同的弹性蛋白酶递送方法进行处理。将动脉安装在充满盐水的流动腔室中。它们接受脉动血流48小时，或直至形成的动脉瘤破裂。通过摄像机记录持续监测变化情况，并用组织学切片进行验证。
所有8条在内膜或外膜表面局部用浓度大于1 U/mm2的弹性蛋白酶处理的动脉均形成了囊状动脉瘤；其中5条在48小时内破裂。所有4条通过微导管向管腔内注入表面浓度为0.1 U/mm2的动脉均形成了梭形动脉瘤。表面浓度低于0.1 U/mm2的动脉均未形成动脉瘤。组织学切片显示，囊状动脉瘤顶部拉伸的胶原基质中的细胞成分数量减少。
在对几种弹性蛋白酶递送方法进行经验性测试后，我们能够在动物动脉标本中诱导出囊状、分叉型动脉瘤。这些动脉瘤在组织学上相似，且比手术模型更真实。该操作简便且可重复。我们的结果表明弹性蛋白酶在动脉瘤形成中可能起作用，并突出了选择性动脉弹性损伤的显著影响。此外，我们实验性动脉瘤的快速生长可能反映了自然过程的速度。
